Efficacy and safety of recombinant human epidermal growth factor combined with fractional carbon dioxide laser for facial atrophic acne scars: a systematic review and meta-analysis of randomized trials

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background The combination of recombinant human epidermal growth factor (rhEGF) and fractional carbon dioxide (CO 2 ) laser therapy is increasingly used in the treatment of facial atrophic acne scars. Objective This study aimed to systematically assess the efficacy and safety of rhEGF combined with fractional CO 2 laser therapy for managing facial atrophic acne scars. Methods PubMed, Embase, the Cochrane Library, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang, SinoMed, and VIP were searched from inception to July 29, 2025. Parallel-group or split-face randomized controlled trials (RCTs) comparing fractional CO 2 laser therapy + rhEGF with fractional CO 2 laser therapy for treating atrophic acne scars were considered for inclusion. Risk of bias was assessed using the Cochrane Collaboration's risk-of-bias tool. The meta-analysis based on fixed or random effects models was carried out for Echelle d'Evaluation Clinique des Cicatrices d'acne (ECCA) scores, Vancouver Scar Scale (VSS) scores, transepidermal water loss (TEWL), etc. It was registered on PROSPERO (ID: CRD42024599311). Results Twelve RCTs involving 1,044 patients were included, and all trials were conducted in China. Follow-up durations across studies ranged from 1 week to 12 months. Compared with fractional CO₂ laser therapy alone, the combination therapy significantly reduced ECCA scores by a me

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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